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PALM BAY RX PHARMACY LLC
STD329351 Specialized Treatment Education and Prevention Services, Inc
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Covered Entity Details
Entity Name
Specialized Treatment Education and Prevention Services, Inc
Subdivision Name
STEPS-Mel
Type
Sexually Transmitted Diseases
340B ID
STD329351
Entity Address
2102 Sarno Road
Melbourne, FL 32935
Grant Number
H25PS005131
Participating Start Date
4/1/2022
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
PALM BAY RX PHARMACY LLC
Pharmacy Address
PALM BAY PHARMACY
1270 MALABAR RD SE STE 2
PALM BAY, FL 32907
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl Bello, Executive Director
(407) 522-2144
Contract Pharmacy Representative
RX One
Sam Sharma, Regional Manager
(321) 952-0656
Signed By Date
4/14/2023
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